Quality Assurance Manager - Behavioral Health

Since 1925 The Child and Family Guidance Center has been serving children and families.  We provide culturally informed mental health care and complementary supports, regardless of ability to pay.  If you would like to be a part of our team and make real difference in people’s lives. The Child and Family Guidance Center is currently seeking a full time Behavioral Healthcare Quality Assurance Manager.  

The Behavioral Healthcare Quality Assurance Manager will ensure compliance with internal and external program standards, including but not limited to state and federal contracts, Medicaid fee-for-service billing, and HIPAA privacy and security rules. The Quality Assurance Manager will play a critical role in monitoring fee-for-service billing by ensuring that electronic documentation is complete, accurate and meets compliance standards for reimbursement by CT DSS/Medicaid and all other funders. The Quality Assurance Manager will perform quality assurance reviews, produce valid and reliable data reports, and coordinate policy, procedure, and standardized form development.

The selected individual will be responsible for but not limited to the following Essential Functions: 

• Maintain government contracts and ensure compliance with licensing and credentialing requirements.  
• Maintain up-to-date knowledge of state and federal regulations, including CT DSS/Medicaid fee-for-service billing, and any changes that occur to ensure compliance with these rules and regulations. 
• Work with program staff, Fiscal Department, and the CEO to develop, implement and monitor effective systems for CT DSS/Medicaid fee-for-service billing; monitor billable services and ensure compliance with program standards.
• Conduct internal quality assurance reviews addressing DSS/Medicaid and state licensing requirements.  Work collaboratively with program staff and agency leadership to share findings from internal reviews and external audits and lead quality improvement initiatives. 
• Produce reliable and accurate outcome data from agency databases to support the agency’s DEI initiatives.
• Provide thorough analysis related to data reports and audits and develop PowerPoint and other types of presentations for internal and external use.
• Implement, monitor, and report on HIPAA privacy and security practices.
• Support development of new policies and procedures and develop and manage an annual review process for all policies, procedures and forms.
• Support case record/chart review processes across programs.
• Maintain comprehensive staff training and development requirements; coordinate, facilitate and assign staff training. Coordinate training and staff development in evidence-based practices.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Qualifications:

• MSW, MBA, MPH, or related MA/MS degree preferred.
• Knowledge and experience with Medicaid reimbursable services preferred
• Two to three years of post-graduate experience in human services or mental health.
• Prior compliance and/or quality improvement experience preferred
• Knowledge and experience with Medicaid reimbursable services preferred
• High level of skill with MS Office software 

EEO Statement:   The Child and Family Guidance Center is an equal opportunity employer, and does not discriminate on the basis of race, color, age, gender, national or ethnic origin, religion, sexual orientation, or physical disability. 

Disclaimer:   The above information on this description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job. 

Other duties, responsibilities and activities may change or be assigned at any time with or without notice. 

website: www.cfguidance.org